NIH would see huge budget cut under president’s proposal

Nurse Floreliz Mendoza holds a syringe used in an experimental Zika vaccine clinical trial at the National Institute of Health Clinical Center in Bethesda, Maryland. (Allison Shelley/For The Washington Post)

The National Institutes of Health would absorb an enormous $5.8 billion cut under President Trump’s first budget proposal — equal to about 19 percent of its current $30.3 billion discretionary budget.

The plan “includes a major reorganization” of NIH’s 27 institutes and centers and would eliminate the Fogarty International Center, a $69.1 million program dedicated to building partnerships between health research institutions in the United States and abroad.

With few details available in the budget outline, it is unclear what kind of reorganization the administration envisions at NIH, the crown jewel of U.S. biomedical research. The agency funds research into a vast array of diseases and conditions, including cancer, heart disease, developmental disorders and mental illness.

The agency passes out more than 80 percent of its money to more than 300,000 researchers at universities across the country and abroad. It also has hundreds of researchers conducting studies in labs at its sprawling campus in Bethesda, Md. Its world-renowned clinical center treats patients from around the world seeking last-chance cures and volunteers testing cutting-edge therapies.

Grants to outside researchers tend to be for several years, giving scientists the confidence that they will have the funding they need for the equipment and personnel necessary to carry out their studies. A cut of this size could prove very disruptive to that research, whether it is applied across the board or to some grants only, one former NIH scientist said.

Similarly, the programs in Bethesda — which include the National Cancer Institute and the National Institute on Minority Health and Health Disparities — employ 18,000 people who almost certainly would be affected by a budget cut of this magnitude.

The Trump plan also would move the Agency for Healthcare Research and Quality, a unit of the Department of Health and Human Services that analyzes and evaluates health-care programs, into NIH.

After more than a decade of treading water financially, NIH received a funding boost in fiscal 2016 under President Barack Obama. It received another cash infusion for fiscal 2017, when funding for then-Vice President Joe Biden’s cancer moonshot and a precision medicine initiative was made available.

Trump’s proposal for 2018 would reverse that trend in dramatic fashion, according to the government’s blueprint. The document promises “other consolidations and structural changes across NIH organizations and activities” beyond the cuts it specifies.